title: Pancreatic cyst prevalence and the risk of mucin-producing adenocarcinoma in US adults.
abstract: OBJECTIVE
  The presence of a pancreatic cyst often prompts concern, although the rate of malignant transformation to mucin-producing adenocarcinoma is not known. We aimed to determine the prevalence rate of mucin-producing adenocarcinoma in US adults with pancreatic cysts.
  
  
  METHODS
  This retrospective, population-based cross-sectional study calculated the annual number of mucin-producing adenocarcinomas using the Surveillance Epidemiology and End Results (SEER 18) database and the 2010 US census. The overall prevalence rate of cysts in the population was found using data from large cross-sectional imaging studies of incidental cyst prevalence. Prevalence rates were then calculated by dividing the annual number of mucin-producing adenocarcinomas by the cyst prevalence rate.
  
  
  RESULTS
  Between 2005 and 2009, 1,137 mucin-producing adenocarcinomas were estimated to be found annually in a US adult population of 137,154,960. The total number of pancreas cysts, given a cyst prevalence rate of 2.5%, was 3,428,874. Therefore, the prevalence rate of mucin-producing adenocarcinoma arising in patients with pancreatic cysts was 33.2 per 100,000 (95% confidence interval (CI): 21.9-44.5). The prevalence rate was 32.8 per 100,000 (95% CI: 21.6-44.0) in women and 33.5 per 100,000 (95% CI: 22.2-44.8) in men. As expected, the rate of malignant transformation increased linearly with advancing age (highest 38.6 per 100,000 in 80- to 84-year-old men).
  
  
  CONCLUSIONS
  Malignant transformation of pancreatic cysts into mucin-producing adenocarcinoma in US adults is a very rare event. Current clinical guidelines and resource allocation for pancreatic cyst disease should be reconsidered given these findings.
authors.affiliation: Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Gardner
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Glass
authors.forename: Kerrington D
authors.initials: KD
authors.lastname: Smith
authors.forename: Gregory H
authors.initials: GH
authors.lastname: Ripple
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Barth
authors.forename: David A
authors.initials: DA
authors.lastname: Klibansky
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Colacchio
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Tsapakos
authors.forename: Arief A
authors.initials: AA
authors.lastname: Suriawinata
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Tsongalis
authors.forename: J Marc
authors.initials: JM
authors.lastname: Pipas
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Gordon
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000453:epidemiology*; D010190:Pancreatic Neoplasms / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D018426:SEER Program; D014481:United States / Q000453:epidemiology